Responding to the Demand: SLPs in the VA

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1 Responding to the Demand: SLPs in the VA By: Micaela Cornis-Pop, Ph.D. Rehabilitation Planning Specialist VACO Rehabilitative Services 1

2 Responding to the Demand! 246 clinical SLPs! 10 research SLPs! 58 audiologists/ speech language pathologists! Staffing levels have been fairly stable for the past five years 2

3 National SLP Statistics (FY05) FY05)! Outpatient visits 88,318 (down 3% from FY04)! Number of unique patients 24,476 (no change from FY04)! Visits per unique 3.27 (down 3% from FY04) Note: SLP inpatient utilization data is not available (reported by DRG or treating specialty. Inpatient data is now included in National Care Database. Source: KLF Workload Report 3

4 Speech-Language Pathology Outpatient Visits VISITS UNIQUES FY99 FY00 FY01 FY02 FY03 FY04 FY05 4

5 Areas of Practice! Dysphagia! Cognitive-communication: geriatrics, stroke, TBI, polytrauma! Voice: laryngectomy, vent dependent! Assistive devices: AAC, CPD! Education: patients, families, providers 5

6 Traineeships! 19 Clinical Fellowships! 42 Masters Traineeships! Competitive site selection using automated standards of excellence! Training to full scope of practice! Staffing, workload, facilities, EBP, outcomes 6

7 Quality of SLP Student Training SPEECH-LANGUAGE PATHOLOGY SCORES Measure Overall (Goal=85) Rated Excellent or Very Good Recommend to Others Choose Training Again As good as Other Training VA-WIDE SCORES Measure Overall (Goal=85) Rated Excellent or Very Good Recommend to Others Choose Training Again As good as Other Training

8 Trainees Considering VA Employment! SLP trainees considering VA employment 45% before training 78% after training! VA-wide 33% before training 66% after training Source: 2006 Learner perception survey, Office of Academic Affiliations 8

9 Hot topics! VA Dysphagia Directive! Polytrauma System of Care! Hybrid Title 38 9

10 VA Dysphagia Directive! VHA Directive Management of Patients with Feeding and Swallowing Problems in Veterans Health Administration Facilities Released ! It is VHA policy that all patients with swallowing or feeding disorders must be appropriately assessed, referred for diagnostic evaluation, monitored, treated, managed, and followed throughout the continuum of care including hospitalization, outpatient care, and when discharged.! SLP had lead role on the multidisciplinary task force charged with developing the directive! SLPs have lead role on multidisciplinary task forces at local facilities charged with developing local policies and procedures to implement the National Directive 10

11 Polytrauma Defined! Trauma to several body parts and organ systems! Occur at the same time! Cause physical, cognitive, or psychosocial impairments and functional disability 11

12 VA Polytrauma System Of Care (PSC) Specialized sites for rehabilitative services! Geographically distributed! Integrate care at one location! Coordinate life-long care across a continuum of services! Interdisciplinary rehabilitation teams! Polytrauma Telehealth Network! Proactive case management 12

13 Organization of the VA Polytrauma System of Care! Regional Polytrauma Rehabilitation Centers (PRC) Regional referrals for acute comprehensive rehabilitation! Network Polytrauma Network Sites (PNS) VISN level referrals for post acute rehabilitation! Facility Polytrauma Support Clinic Team (PSCT) Polytrauma Point of Contact (PPOC) 13

14 Comprehensive Care for the Polytrauma Patient Audiology Program Hearing Loss & Tinnitus Blast Injury Patient Head Injury Traumatic Brain Injury Rehab Blind Rehabilitation Vision Loss Amputations Emotional Shock Orthopedic & Soft Tissue Trauma PTSD Treatment Amputee Rehabilitation Wound and Physical Medicine Care 14

15 Role of SLPs in Polytrauma Rehabilitation! SLP is core discipline in interdisciplinary team! Supplemental funds to support SLP positions at PRCs and PNSs! Participate in program development! Educational activities as providers and beneficiaries 15

16 Hybrid Title 38! Audiologists and SLPs added to Hybrid Title 38 as of December 6, 2003 (PL )! New qualification standards approved! Special one-time boarding of all employees during FY06! Professional standards boards have been implemented, one national and four regional boards! Goal: Improved recruiting and retention 16

17 Productivity! Joint Audiology and SLP Task Force! Collaboration with ACA and Physician Productivity Group! Productivity model development! Alpha testing at selected sites 17

18 Thanks for Listening 18

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